My 82 yo mother with CHF and dementia was sent from hospital to nursing home for rehab after having pneumonia in December. Due to her declining health and mental state we decided it was necessary for her to stay in the memory care unit of the facility.
Since she doesn’t have any assets we applied for Medicaid coverage once her 21 days of Medicare coverage were over. She has now been moved to a much smaller shared room and is in the memory care area of the facility.
Since this change her health has declined, she is not helped into clean clothes and is left to lay in the bed all day. Is this normal care? I feel like it borders on neglect but am not sure if I am just expecting too much.
Would love to know what others have experienced with a loved one on Medicaid in a skilled nursing home. Thanks in advance.
It is common for a resident to be moved to a room (many times smaller) when they apply for Medicaid. Residents have to be in a vendor bed (Medicaid approved bed) before application to Medicaid can be made. However, there should not be a decline in the care the resident receives.
If you are seeing a decline in care talk to the nurse, if you don't get resolution talk to the Director of Nursing. If you still don't see a change contact your local Ombudsman Program. Ombudsman are Federally Mandated Advocates for resident in long-term care facilities. They can help with this and there is never a charge to the resident or family!
In turn, the patients do not receive the care they deserve and need. Any patient with cognitive issues, will suffer more, as they cannot advocate for themselves. Also, in SNF the caregivers do not know the patients well, so if they are told no, they take that as the last word. They don’t have the time to spend, to redirect or work with the patients with cognitive issues.
It’s imperative that family and friends get involved, and are diligent in advocating for the proper services that their loved one needs.
I know to ask about medication, daily routine but what specific questions would you guys with experience recommended?
What are her vitals? BP/ pulse /temp
What are her meds? Ask to see their list.
Is she continent or have any urine/bowel issues?
What is her weight? You need a baseline.
What % is she eating and drinking at every meal?
What is the shower/hair wash schedule?
Is she walking? If not, that should trigger restart of PT.
Does she participate in any activities?
Many of these questions will come up in the general flow of conversation but some details may not, so it’s good to have a list.